Last week, Congress included a one-year delay to Protecting Access to Medicare Act (PAMA) cuts to clinical laboratory fees in the short-term funding bill later signed into law. The one-year delay for PAMA cuts prevented targeted payment reductions up to 15% by delaying the reporting and collecting of private insurance payments for clinical laboratory services and extending the zero-percent cap on payment reductions through 2024. This is the fifth time Congress has intervened on a bipartisan basis to delay the next CLFS reporting periods and the fourth time they have intervened to delay cuts to maintain access to laboratory services for patients. In 2014, Congress passed PAMA, to reform the Medicare clinical laboratory fee schedule (CLFS) to a single national fee schedule based on private market data from all types of laboratories that service Medicare beneficiaries, including independent laboratories, hospital outreach laboratories, and physician office laboratories (POLs). Unfortunately, the first round of data collection in 2017 failed to capture an adequate and representative sample of private market data, leaving out virtually all hospital outreach laboratories and significantly under-sampling POLs. The significant under-sampling led to nearly $4 billion in cuts to those laboratories providing the most commonly ordered test services for Medicare beneficiaries. For context, the total CLFS spend for 2020 was only $8 billion, less than 3% of Medicare Part B spending. While Congress has delayed drastic cuts of up to 15%, without a sustainable solution to this problem, laboratories will face further rounds of cuts in 2025. The Saving Access to Laboratory Services Act, or SALSA (S.1000/H.R. 2377), is a permanent solution that would set Medicare reimbursement for clinical laboratory services on a sustainable path forward. SALSA will give the Centers for Medicare and Medicaid Services (CMS) new authority to collect private market data through statistically valid sampling from all laboratory segments for the widely available test services where previous data collection was inadequate. The bill ensures true private market rates are included and provides a much-needed reduction in the reporting burden. By providing a gradual phase-in approach, the bill protects clinical laboratories, the Medicare program, and patients from the impact of dramatic rate increases or decreases. In April, the CAP joined other industry stakeholders, including the American Medical Association and the American Clinical Laboratory Association, in sending a letter of support to congressional leadership urging the passage of SALSA. "We're afraid that SALSA is caught up in kind of the quagmire of chaos that is going on in Congress," said Donald Karcher, president of the College of American Pathologists, noting that this "probably lessens the likelihood that it might go forward." "We're always hopeful, but not super optimistic at this point," he said. Urge Congress to pass SALSA today!